The Clinical Research and Patient Care Core programs for this center application are based in the East Bay at Children's Hospital-Oakland, Alta Bates Hospital-Berkeley and Highland General Hospital-Oakland and in the West Bay at San Francisco General Hospital/University of California, San Francisco. The large patient population enrolled in these cooperative clinical programs provides us with an ideal resource to conduct the clinical and basic research projects and plan new research projects. The success of these interactions is reflected in our publications related to basic and clinical research on sickle cell disease, (listed in the summary progress report), in our participation in national efforts to establish treatment guidelines for patients with sickle cell disease and in our contributions to implement newborn screening for sickle cell disease. This application describes a number of new clinical research projects: 1) Acute Chest Syndrome, 2) Pediatric Hydroxyurea Trial, 3) Bone Marrow Transplantation, 4) Gamma Interferon- Pneumococcal Vaccine Trial, 5) Longitudinal studies of children up to three years of age and 6) the efficacy of Ketorolac to control pain in patients with vaso-occlusive crises. In addition to the above projects the core will provide necessary blood samples for many basic research programs. In summary, the strength of the clinical core in our Center application will enable us to complete successfully the proposed clinical research projects and participate in the basic research projects.